When I attended my first practice manager meeting many, many years ago, I thought to myself, ‘What a bunch of cynics! That’s never going to be me.’

My positivity did last for a fair few years; through the first five years, I was still certain that I could effect change and I wasn’t going to want to poke the next receptionist in the eye who came knocking on my door weeping, requesting time off because her pet rat had a urine infection. I was going to be different.

After five years of flying the practice manager flag, something changed. It wasn’t the patients or, surprisingly, even the staff (though why anyone else in the building can’t change a light bulb or unblock a toilet is beyond me!). Instead, it was the feeling that nothing I did changed the ‘bigger picture’. I’d joined every forum and group possible, but my enthusiasm steadily waned over the next five years.

All of a sudden, it had been ten years and even I was commenting on the unrealistic expectations placed on general practice. Yet, in the media, I was reading that GPs were entirely to blame for the failing of the whole health system. It was thoroughly depressing.

It’s hard to stay positive when we continually have negativity hurled at us. As a result of this, most of our forums are filled with stories of stressed managers, crying managers, exasperated managers and managers who’ve had enough.

How do you stay positive?

I’ve always believed that if the situation is that bad, and the job is that bad, and you’ve tried everything you can to change it, and if your physical and/or mental health is getting worse, then you can and must change the situation. It sounds hard but if you’re in a job that’s making you unhappy, then look for another one. A change really is as good as a rest. We’re frightened of change, but change can be so exciting. Don’t be in a job you hate. Don’t do it!

However, if you decide to stay, what can you do to make things better? I believe that not working beyond your hours is crucial. It’s so tempting, but continue to do this and there will never be evidence that more staff are required; the partners will turn a blind eye to it as it looks like you’re coping. Don’t check emails when you’re not in work – why would you? What possibly can’t wait? Work within your remit – we’re not accountants, counsellors or mortgage brokers; that sort of work should be out-sourced and expert advice should be sought. We’re good at what we do, but we can’t be an expert in every area or keep up to date with all the latest legislation and be expected to run a practice of thousands of patients, with tens of staff to manage. It’s impossible.

Have a break every couple of hours – get up, make a drink, have a chat, even if it’s for five minutes. You’ll feel better. Have lunch! Make sure you eat! The number of times I hear managers say that they haven’t eaten all day, or they haven’t had time for lunch – you’ll just work much less effectively! Take your holidays too; nobody in our job should ever be carrying over holidays from one year to the next. You need a holiday!

Delegate! I think every PM needs a deputy, and a good one at that. Meet them regularly and make sure their workload is doable. Treat them as you’d like to be treated yourself; create a good relationship and rapport. They should be someone who, when you walk out of the door, you feel the place is in safe hands. If it isn’t like that, then the issue needs addressing. Responsibility for the whole practice can’t be on your shoulders alone.

Get the partners involved. Many shy away from the day-to-day stuff and it’s true we’re being paid to manage, but they are the partners! Don’t be scared to put responsibility on them. We’re not superheroes! They have the ultimate responsibility for the partnership and they’re earning the money to match the responsibility! Have regular meetings, ask them to make decisions, and minute those decisions.

I’m just a practice manager like you. You’ll know most of this already, but sometimes we need reminding. There are so many of us who are struggling right now, so perhaps look at this as a friendly reminder that you can change your situation. And remember, you’re supposed to be working a set number of hours a week, so make sure you have time during the week to do other things too – like sleeping!

I’ll leave you with a quote from Oprah Winfrey: “The greatest discovery of all time is that a person can change their future by merely changing their attitude.”

Have a lovely week!

PM Polly